Results of concurrent chemoradiotherapy (CRT) with low dose weekly gemcitabine (G) in stage III non-small cell lung cancer (NSCLC)

Abstract

7318 Background: Combined CRT is the treatment of choice for stage III NSCLC. G is a novel deoxycitidine analogue that has been proven to be a potent radiosensitizer. To demonstrate the tolerability and efficacy of low dose G given weekly as a radiosensitizer in stage III NSCLC, 22 patients were treated with concurrent CRT. Patients and Methods: Patients with KPS ≥70, adequate bone marrow reserve, without prior RT and surgery were included. Eighteen patients had received prior induction CT. G (75 mg/m2/week) was infused over 1 hour for 6 weeks. Two hours later thoracic RT was given over 6 weeks with 1.8 Gy/day (total dose 61.2 Gy). Pulmonary toxicity was evaluated with CT scans 6 weeks after RT and treated accordingly. Results: Median follow-up was 15 months (range, 2–40). Half of the patients had stage IIIA disease. Median age was 60 years (range, 48–75), 68% were male and median KPS was 90. Conformal 3D RT planning was used in 64% of patients. G was given for a median of 5.5 weeks (range, 1–9). Twelve patients (54.6%) received all planned CT. G was stopped because of intolerance (grade 2 nausea/vomiting, neutropenia and grade 3 esophagitis) in 6 and death in 2 patients. Eight patients (36.4%) had radiation pneumonitis, 7 were grade 1/2 and 1 was grade 5. One patient (4.5%) had clinical CR, 81.8% had PR while 9.1% had SD. Sixteen patients died, 6 with progression of primary, 8 due to metastatic disease, 1 with pulmonary toxicity and another one with cerebrovascular accident. Conclusion: Gemcitabine used as radiosensitizer during the primary RT of stage III NSCLC patients is a promising agent revealing increased local control with tolerable toxicity profile in patients with good performance status. No significant financial relationships to disclose.